The human brain produces cerebrospinal fluid (CSF) as part of its normal function. CSF is known to have multiple functions, such as buoyancy, shock protection of the brain parenchyma, biochemical and immunological action.

The production, circulation and absorption of CSF is a continuous and automatic function of the brain, and its disruption leads to accumulation of excess fluid in the brain. This pathological condition is defined as hydrocephalus.

Hydrocephalus is divided into communicating (cases where there is no obstruction in the circulation of the CSF) and obstructive (cases with a mechanical obstruction in the circulation of the CSF).

Cases of communicating hydrocephalus include post-hemorrhagic, post-infectious, post-operative hydrocephalus, as well as congenital diseases such as myelomeningocele. Obstructive type hydrocephalus is found in aqueduct stenosis, tumors of the third or fourth ventricle, tumors in the region of the conary, entrapment/compartmentalization of part of the abdominal system, Chiari syndrome.

The clinical picture of hydrocephalus in children varies according to their age. Thus, in children younger than 2 years, who have not yet completed the convergence of the cranial sutures and springs, an increase in the head circumference, dimension of the seams, dilatation of the veins of the skin of the head, propecia of the anterior source (in cases where this is still open). Other characteristic signs are vomiting, the reversal of psychomotor development, the drop in the level of consciousness, an epileptic episode, the point of the setting sun (deviation of the gaze downwards).

At ages over 2 years, the clinical picture is similar to that of adults (headache, nausea/vomiting, blurred vision, change in level of consciousness) varies between shallowness, lethargy, coma.

In the diagnosis of the cause, imaging with an axial or magnetic resonance imaging of the brain is primarily preferred. In newborns and infants up to six months of age, brain ultrasound through the open anterior source can also be useful.

The treatment of hydrocephalus depends on the cause that causes it. In cases of communicating hydrocephalus, the best treatment is to install a valve. Placement of an abdominal-peritoneal drain is more common (excess CSF is drained into the abdomen). Alternatives are drainage to the right heart atrium, to the thoracic cavity or, rarely, to the gallbladder or even the urinary bladder.

In cases of obstructive type, the neurosurgeon may place a valve or perform a third ventriculostomy (creation of an opening using an endoscopic camera in the floor of the 3rd ventricle in order to bypass the point of obstruction). The 3rd colostomy offers in these cases the alternative of avoiding the placement of a foreign body in the patient, with all that entails (increased risk of infection, malfunction or failure of material, need for future reoperation).

Regardless of the choice of the above treatment methods, modern neurosurgery is able to offer solutions to young patients with the aim of integrating them into everyday life as best as possible.